A Clinical Analysis And Study Of163Cases Of Dermatomyositis

Objective: Analyse the relationship from many angles, the relationship isbetween dermatomyositis clinical features, risk factors, main factors forprognostic(especially the rash, immunity index, Interstitial lung disease,tumour), other clinical features and laboratory parameters.Methods: Analyse the Clinical data of163patients in our hospital, do thestatistic of the clinical features of dermatitis and myositis, then analyse theother clinical features and laboratory parameters from different angles, suchas concurrent ILD, expression of the anti-JO-1antibody, and the expression ofthe Gottron rash, simultaneous tumors etc. analyse the clinical data ofdermatomyositis co-infection and death, to investigate the predisposingfactors and prognostic factors.Results: Between the163cases of DM patients, muscle weakness, muscletenderness, Gottron’s rash, periorbital edema, purple erythema incidence weresignificantly higher than other symptoms,102cases (62.6%),108cases(66.3%),96cases(58.9%),153cases (93.9%) respectively. The group whichwere combined with ILD have higher incidence of arthralgia,elevated IgG andanti-Jo-1antibody-positive than the group without ILD((P<0.05). Howeverthe ILD group have lower Gottron’s rash incidence(P<0.05). The group which were anti-Jo-1antibody-positive have higher incidence of Joint pain,lung infection, fever, anti-SSA/SSB antibodies positive and Elevated IgGthan anti-Jo-1antibody-negative group(P <0.05). But anti-Jo-1antibody-negative group have significant more frequence of Gottron’s rashthan anti-Jo-1antibody-positive group(P <0.05). The Gottron’s rash positivegroup have lower incidence of ILD(16.6％) than the Gottron’s rash negativegroup (53.7％). The infective group and no-infective group have significantdifference in Age (≥60years), ILD, difficulty swallowing, diabetes, thecurrent hormone dosage (≥40mg/d), the cumulative hormone dosage (≥1g), and the number of steroid pulse therapy(P <0.05). This study found thatolder age of onset, complication with malignant tumor, ILD were associatedwith poor outcome. Continuous hormone therapy (RR=0.45, P=0.0047)and sustained immunosuppressive therapy (RR=0.52, P=0.035) wereprotective factors for DM.Conclution:1.The group which were combined with ILD have higherincidence of arthralgia, elevated IgG and anti-Jo-1antibody-positive than thegroup without ILD((P <0.05). However the ILD group have lower Gottron’srash incidence(P <0.05).2.Anti-Jo-1antibody is closely related to the DMcombined with ILD, more of the Anti-Jo-1antibody positive patients startingwith myositis symptoms, respiratory symptoms, and polyarthritis.3.Gottron’srash-positive patients have less chance to have ILD, and the lesions may be lighter.4.Dermatomyositis complicated with malignant tumor is common inpatients over age40, the most common complicated malignant in our regionwere lung cancer and nasopharyngeal carcinoma.5.The elder age (≥60years), interstitial lung disease, difficulty swallowing, and high-dose hormonetherapy (cumulative hormone dosage of≥1g) were predisposing factors fordermatomyositis patients to get infections.6. Complication with malignanttumor and ILD were associated with poor outcome, however continuoushormone therapy and sustained immunosuppressive therapy were protectivefactors for PM and DM.